Presenting author biography:

Chris Rintoul and Buff Cameron work as managers in Extern, the provider of the innovative DASP project. They each have 15+ years of experience in working with complex needs such as homelessness and addiction. Their backgrounds in social work and drug user activism led them to develop the project.

Preventing opioid overdose fatalities in a Belfast homeless hostel

Chris Rintoul, Buff Cameron

The Drug Accommodation Support Project (DASP) was established in 2010 to accommodate homeless active heroin injectors in a part of a hostel in central Belfast, Northern Ireland (NI). Prior to this there was no accommodation for this group of vulnerable homeless people; fatal overdoses were common in the city centre area. In the pre-ceasefire era homeless heroin users were sometimes summarily executed by paramilitary organisations. Since the ceasefires however this group were still multiply excluded from services, including accommodation services. Staff were trained in all aspects of the management of on-site drug use and in provision of an effective accommodation service to them. Legal barriers to DASP were overcome with an agreed multi-agency protocol signed up to by criminal justice, health and accommodation services. 92 people have been assisted by DASP with accommodation and support. In 2011 NI established a countrywide Take Home Naloxone scheme, enabling this client group to receive naloxone and be trained in it's administration. Since 2012 a total of 746 naloxone kits have been issued, 58 have been used and on 54 occasions the overdosed casualty survived. On 25 occasions it has been administered to DASP clients in the hostel, on every occasion preventing loss of life. For every £250 spent on naloxone, one person has been survived an overdose. The staff have become extremely confident and competent in dealing with overdoses. Another positive impact is that upon successful evaluation, it has been agreed to expand the service enabling more homeless injecting drug users are accommodated and supported by competent, confident staff which has then created opportunities for these IDUs to engage in wider healthcare services such as NSP and addiction treatment services including OST. Challenges such as lack of access to OST remain the biggest obstacle to being able to move people into independent accommodation.